<p>Пополнение счёта пользователю <strong>$mail$</strong> (<strong>$ip$</strong>)</p>
<FORM name="payment" accept-charset="UTF-8" action="pay" method="post">
<DIV class="form-tab">
<TABLE cellspacing="5" cellpadding="3" border="0">
<TR>
<TD class="form-field" align="right">Сумма (грн)</TD>
<TD class="form-field" align="left"><INPUT type="text" class="form-field" size="6" name="paysum" value="0.00"></TD>
</TR>
<TR>
<TD class="form-field" align="right">Комментарий</TD>
<TD class="form-field" align="left"><INPUT type="text" class="form-field" size="80" name="comment" value="Оплачено наличными">
<INPUT type="hidden" name="uid" value="$uid$">
</TD>
</TR>
<TR>
<TD><INPUT type="submit" class="form-button" value="Пополнить"></TD>
</TR>
</TABLE></DIV></FORM>